orbital cellulitis


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orbital cellulitis

cellulitis that involves the tissue layers posterior to the orbital septum.

orbital cellulitis

Ophthalmology Acute infection of the tissues of the eye, with potentially serious complications Etiology Bacterial infection, usually an extension from the ethmoid or para-nasal sinuses, regional abscesses, trauma to eye, or foreign object Agents H influenzae, S aureus, S pneumoniae, beta hemolytic streptococci

or·bi·tal cel·lu·li·tis

(ōr'bi-tăl sel'yū-lī'tis)
Cellulitis that involves the tissue layers posterior to the orbital septum.

cellulitis

(sel?yu-lit'is ) [ cellula + -itis, ]
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CELLULITIS
A spreading bacterial infection of the skin and subcutaneous tissues, usually caused by streptococcal or staphylococcal infections in adults (and occasionally by Haemophilus species in children). It may occur following damage to skin from an insect bite, an excoriation, or other wound. The extremities, esp. the lower legs, are the most common sites. Adjacent soft tissue may be involved. Affected skin becomes inflamed: red, swollen, warm to the touch, and tender. Spread of infection up lymphatic channels may occur. Cellulitis involving the face is called erysipelas. When it affects the lower extremities, cellulitis must be differentiated from stasis dermatitis, which is associated most commonly with bilateral, chronic dependent edema and, occasionally, with deep venous thrombosis. Risk factors for cellulitis include diabetes mellitus, lymphedema, venous stasis or insufficiency, immune suppression, injection drug use, malnutrition, peripheral vascular disease, and previous skin diseases. See: illustration; necrotizing fasciitis

Etiology

Bacteria gain access through breaks in the skin and spread rapidly, overwhelming normal body defenses; lesions between the toes from athlete's foot are common entry sites.

Treatment

For mild cases of cellulitis, oral antibiotics may be effective depending on the causative organism. For severe cases, intravenous penicillinase-resistant penicillins are used; surgical débridement to obtain cultures and to rule out fasciitis is recommended for patients with diabetes.

CAUTION!

Rarely, group A streptococcal cellulitis may be complicated by exfoliative dermatitis or infection of the subcutaneous fat and fascia, causing necrosis (necrotizing fasciitis), a condition popularly ascribed to the action of “flesh-eating bacteria.”

Patient care

Blood cultures should be obtained from patients with cellulitis to assess for sepsis before beginning therapy with antibiotics. The affected body part should be elevated above the level of the heart. Outlining the affected area with a skin marker allows the caregiver to readily determine if inflamed tissues are responding to therapy. Size, shape, color, and temperature of the affected area and surrounding tissues should be documented and any drainage described. Applying warm soaks to the area increases vasodilation, thus decreasing edema and relieving pain. Pain should be treated with prescribed oral analgesics and anti-inflammatory drugs. Blood sugars, if elevated, should be lowered to normal levels (preferably about 126 mg/dl or less). Patients on prolonged bedrest should be given heparin to prevent deep venous thrombosis as well as stool softeners to prevent constipation. Patients who develop cellulitis are often at risk for recurrence; they should learn general skin hygiene, how to clean cuts, scratches, cracked skin, and abrasions, and the importance of prompt treatment for infections.

dissecting cellulitis of the scalp

An inflammatory pustular disease of the scalp, similar to acne conglobata or hidradenitis suppurativa. It can be treated surgically, with isotretinoin, or with laser therapy. Synonym: perifolliculitis capitis abscedens

eosinophilic cellulitis

A rash marked by firm, swollen, itchy patches that appear suddenly. The patches may be oval or circular, violet or red, and are associated with abnormally high blood eosinophil levels. The cause is unknown.
Synonym: Wells syndrome

orbital cellulitis

Postseptal cellulitis.

pelvic cellulitis

Parametritis.

periorbital cellulitis

Preseptal cellulitis.

postseptal cellulitis

Facial infection invading the orbit. Synonym: orbital cellulitis

preseptal cellulitis

Soft tissue infection limited to the tissues anterior to the orbital septum. Synonym: periorbital cellulitis
illustrationillustration

orbital cellulitis

Inflammation of the soft tissues in the bony cavern which encloses and protects the eyeball. There is great pain, swelling of the eyelids, bulging of the CONJUNCTIVA and often protrusion of the eyeball. Urgent antibiotic treatment, and sometimes surgical drainage of pus, are needed.

cellulitis, orbital 

Infection of the orbital contents caused by Staphylococcus aureus, Streptococcus or Haemophilus influenzae. It is often caused by the spread of infection from adjacent structures, especially the sinuses. The clinical signs are fever, pain, proptosis, redness, swelling of the lid and orbital tissue and restricted eye movements which may occasionally lead to diplopia and, as the condition worsens, visual acuity decreases. Initial management consists of parenteral antibiotics but surgery may become necessary. See lamina papyracea.
References in periodicals archive ?
Within a few days, the patient's fever, orbital cellulitis, proptosis, and palatal necrosis had almost resolved.
It is only late in the progression of the disease that bony erosion will appear: In our patient, various degrees of mucosal thickening within the nose and sinuses were noticeable and the appearance of orbital extension was similar to that seen in bacterial orbital cellulitis, yet the bony framework was intact.
Sex and type of treatment Medical Endoscopic Open surgical Infection M F management surgery procedure Periorbital cellulitis 15 6 All 0 0 (n = 21) Orbital cellulitis 4 2 All 0 0 (n = 6) Subperiosteal abscess * 9 2 All 7 5 (n = 12) Orbital abscess 5 0 All 0 5 (n =5) * One of these patients also had a supraorbital abscess.
Evaluation of orbital cellulitis and results of treatment.
SOU can be useful in differentiating between orbital cellulitis and subperiosteal abscess secondary to acute ethmoiditis in children.
Orbital cellulitis appears on B-mode imaging as an echodense mass between the globe and the lamina papyracea.
In a previous publication, we reported that SOU is useful in differentiating between orbital cellulitis and subperiosteal abscess in seven children who had sinus-induced orbital infections.
Based on the clinical examination and CT, the orbital involvement could have been a tumor or orbital cellulitis secondary to the nasal aspergillosis.
Shuttleworth et al reported a case of orbital cellulitis in a 16-year-old girl after a zygoma fracture; they concluded that antibiotic prophylaxis is necessary in all cases to prevent infectious complications.
Ben Simon et al conducted a retrospective analysis of their institutional data on orbital cellulitis after orbital blowout fractures and found only 4 cases among 497 patients.
Orbital cellulitis or abscess may lead to thrombosis of the superior ophthalmic vein, which may lead to cavernous sinus thrombosis.